Percutaneous peritoneovenous shunt for treatment of refractory ascites.
OBJECTIVE
To evaluate the usefulness of a percutaneously placed peritoneovenous shunt (PVS) in patients with refractory ascites.


METHODS
Under fluoroscopic and ultrasonographic (US) guidance, the authors placed a PVS in 55 patients (39 men and 16 women; mean age, 56 years) with refractory ascites and symptomatic abdominal distention. The cause of ascites was liver cirrhosis (n = 36), carcinomatosis (n = 17), ruptured cysts with polycystic kidney disease (n = 1), and idiopathic refractory ascites (n = 1). The authors retrospectively evaluated technical feasibility, shunt patency, complications, and clinical outcomes of each patient.


RESULTS
The technical success rate was 100%, and symptomatic improvement was achieved in all but one patient. Complications occurred in 17 of the 55 patients (31%): five patients had variceal bleeding; three patients had ascites leakage; two patients each had disseminated intravascular coagulopathy, transient abdominal pain, shunt infection, and venous thrombosis; and one patient had pulmonary thromboembolism. Thirty patients (54%) died 2-690 days after the procedure (mean, 117 days), and their lifetime shunt patency was 84%. Eight patients were lost to follow-up. Seventeen patients were alive for 60-1,200 days, and their shunt patency was 71%. There was no significant difference in shunt patency between the two groups with benign and malignant ascites.


CONCLUSIONS
The percutaneous placement of a PVS was a technically feasible and effective method for symptomatic relief of refractory ascites.
Won
Jong Yun
JY
Departments of Radiology, Yonsei University College of Medicine, #134 Shinchon-dong, Seodaemun-gu, 120-752, Seoul, Korea.
Choi
Sun Young
SY
Ko
Heung-Kyu
HK
Kim
Seung Hyung
SH
Lee
Kwang-Hun
KH
Lee
Jong Tae
JT
Lee
Do Yun
DY
D001201:Ascites / Q000000981:diagnostic imaging / Q000209:etiology / Q000401:mortality / Q000601:surgery*; D005240:Feasibility Studies; D005260:Female; D005471:Fluoroscopy; D006801:Humans; D008297:Male; D008875:Middle Aged; D010536:Peritoneovenous Shunt / Q000009:adverse effects / Q000401:mortality; D015641:Radiography, Interventional; D012189:Retrospective Studies; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional; D014654:Vascular Patency